How to Succeed on Primary Care and Community Placements

How to Succeed on Primary Care and Community Placements offers practical advice on how to get the most from your time on community visits, within patient consultations, and with the practice team. It highlights the unique opportunities and challenges you will face on placement, from using clinical information systems, to home visits and long term patient relationships, and how to take advantage of new ways of learning with web-based tools, mobile devices and social networking.

Key features include:

• Learning outcomes at the start of each chapter with links to web-based learning, case examples, and tasks to undertake whilst on placement
• An evidence-based, practical approach to improving learning, teaching, assessment and feedback in community settings

Written by a team of experienced community-based medical education specialists, it is ideal for all medical students, whether on early clinical placements or later in training, and for tutors and preceptors looking for novel ways to engage their students.

David Pearson is a?General Practitioner and?Director, Academy of Primary Care, Hull York Medical School, York.

Sandra Nicholson is Lead, Academic Unit for Community-Based Medical Education, Barts and The London School of Medicine and Dentistry, London.

Contributors, x

Introduction, xi

Acknowledgements, xv

Chapter 1: What to learn in community settings, 1
With Ann O’Brien

Introduction, 1

Early years, 3

What to learn during early patient contact, 4

Professionalism and personal growth, 5

Patient perspectives on health and healthcare, 8

Social and psychological aspects of health, 9

Learning clinical method (history taking and examination), 11

Clinical and procedural skills, 13

Middle clinical years, 14

Later clinical years, 22

Learning in the community ‘out of hours’, 25

Further opportunities, 26

Summary, 29

References, 29

Further resources, 30

Chapter 2: Learning the public health aspects of medicine, 32
With Ann O’Brien

Public health perspectives, 32

Health promotion, 35

Primary and secondary disease prevention, 36

Behaviour change: health promotion and prevention for individuals, 38

Public health and health education, 39

Summary, 41

References, 41

Chapter 3: Preparing for and learning on primary care and community placements, 42
With Maria Hayfron�]Benjamin

Introduction, 42

Preparing for your community placements, 45

When you arrive on placements, 47

Your responsibilities at the end of your placement, 59

Summary, 60

References, 61

Chapter 4: Active learning in the consultation, 62
With Catie Nagel

Introduction, 62

Learning objectives, learning plans, 63

Learning consultation skills, 64

Understanding the consultation, 65

The art of consultation, 66

Engaging with patients, introductions, information, consent, 67

Working with patients, 68

Active learning in the consultation, 71

Student�]led consultations, 76

Problems, pitfalls and suggested solutions, 77

Complex consultations for the later clinical years, 79

Summary, 82

References, 83

Chapter 5: What to learn from the primary healthcare team, 85
With Will Spiring and Ann O’Brien

Introduction, 86

Professional behaviour in a team, 87

What the PHCT does, 90

Learning with and from the primary healthcare team, 95

Learning from the practice nurses, 98

Learning from the pharmacy team, 100

Primary health team meetings, 105

Learning from mistakes, 106

Patients and public involvement in your education, 107

Summary, 109

References, 109

Further resources, 110

Chapter 6: Learning medicine in community settings, 111
With Ann O’Brien and Will Spiring

Learning from community visits, 112

Learning from doctor’s home visits, 113

Visiting residential care and nursing homes, 115

Learning from community mental health teams, 116

Long�]term mental healthcare in the community, 119

Community mental health for the elderly, 120

Community maternity and child health services, 121

Community sexual health services, 122

Palliative and end of life care, 123

Summary, 126

References, 126

Further resources, 127

Chapter 7: Clinical information systems, opportunities to learn, 128
With Jane Kirby

What are clinical information systems?, 128

Why learn about clinical information systems?, 129

Clinical information systems in community practice, 130

Making the most of the CIS in learning and teaching, 130

What do clinical information systems offer in the diagnosis and management of acute illnesses? How do they support your learning of these conditions?, 132

How do clinical information systems support the management of long�]term conditions? How can they support your learning about this vital area of medicine?, 134

Learning from clinical guidelines, 138

How can clinical information systems support the learning of prescribing (and patient safety)?, 139

Family medicine, using clinical information systems to learn public health aspects – what do you need to know?, 141

Clinical information systems: supporting learning about communication with patients, and colleagues, 143

Using clinical information systems in supporting assessment, 144

Clinical information systems: problems and pitfalls, 145

Clinical information systems: projects, audit and research, 148

Summary, 149

References, 150

Chapter 8: Supporting learning in primary care using social media and other technologies, 151
With Jonathon Tomlinson

Social media in your primary care placements, 152

When media becomes social media, 153

Social media landscape, 154

Your online profile and digital professionalism, 155

Your digital footprint, 155

Doctors and patients online, 156

Digital literacy and information literacy, 157

Social media sites: Facebook, Twitter, Blogs, Wikis, YouTube, Slideshare/Prezi, Scoop.it/Pinterest, 159

Summary, 164

References, 165

Further resources, 166

Chapter 9: Assessment, feedback and quality assurance, 167
With Mark Williamson

Assessment in your primary care placement, 168

Assessments in medical courses, what should you expect?, 169

What types of assessment should you expect on your primary care placements?, 171

How can you best use your time on primary care placements to survive (or even excel) in your medical school assessments?, 174

Some potential strengths of assessment in primary care, 177

Opportunities for self�]assessment in primary care settings, 181

Some final thoughts: why authenticity in assessment matters, 181

Feedback within your primary care placement, 182

Types of feedback in primary care placements, 184

Giving and receiving feedback, 187

Giving something back – your responsibility to offer feedback, 188

Summary, 191

References, 192

Chapter 10: Conclusions: Looking to the future, 194

Reference, 197

Index, 198

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